A Case of Obstructive Sigmoid Colon Cancer Resected following Metalic Stenting for Hypermagnesemia Caused by Bowel Preparation

Abstract

A 72-year-old woman presented to our hospital with hematochezia. After close examinations, she was diagnosed with sigmoid colon cancer cT4aN0M0 cStage IIb, and a surgery was scheduled. On the day before the surgery, mechanical bowel preparation using sodium picosulfate hydrate, magnesium oxide, and anhydrous citric acid was performed. In the morning of the surgery, the patient developed disturbance of consciousness, septic shock due to colitis obliterans, acute renal failure, and hypermagnesemia. Continuous hemodiafiltration dialysis (CHDF) was performed for hypermagnesemia, and her serum Mg level decreased and her consciousness disorder improved. After colorectal stenting and bowel decompression for obstructive colorectal cancer, her general condition improved, and the primary tumor resection was performed as a standby procedure. The patient is now recurrence-free as of 10 months after surgery. The patient had hyperglycemia due to mechanical bowel preparation, but was safely treated with CHDF and colorectal stenting.